title: Validity of self-reported sunscreen use by parents, children, and lifeguards.
abstract: BACKGROUND
  Verbal self-report is the method most often used to assess sunscreen use, but the data may be confounded by recall error and social desirability. Sunscreen swabbing is a non-invasive procedure to objectively assess the presence of sunscreen on the skin. This study examined the agreement between verbal reports of sunscreen use from survey and diary measures and objectively measured sunscreen use.
  
  
  METHODS
  Participants were 564 parents, children aged 5-10 years, and lifeguards at 16 swimming pools in four regions of the U.S. Participants completed self-reported measures, including baseline and final surveys, as well as a 4-day diary and objective swabbing measures of sunscreen presence on 2 separate days. Data were collected in 2006 and analyzed in 2006-2007.
  
  
  RESULTS
  Levels of sunscreen use were relatively high based on surveys (65.7%); diary data (40.3%); and swabbing measures (59.1%). Agreement between swabbing and diary measures of sunscreen use was fair to good, with kappa statistics for children at 0.40, followed by lifeguards at 0.34 and parents at 0.27. Validity coefficients across measures of sunscreen use were higher for lifeguards and parents than for children, and diary measures were higher than surveys. No systematic errors were found across groups or by gender, latitude, study arm, or risk category.
  
  
  CONCLUSIONS
  These findings are comparable to those in other validation studies, including studies of the validity of dietary assessments. Self-reported estimates of sunscreen use by diaries or surveys appear to be as good as objective measures.
authors.affiliation: Rollins School of Public Health, Emory University, Atlanta, Georgia 30322, USA. kglanz@sph.emory.edu
authors.forename: Karen
authors.initials: K
authors.lastname: Glanz
authors.forename: Frances
authors.initials: F
authors.lastname: McCarty
authors.forename: Eric J
authors.initials: EJ
authors.lastname: Nehl
authors.forename: David L
authors.initials: DL
authors.lastname: O'Riordan
authors.forename: Peter
authors.initials: P
authors.lastname: Gies
authors.forename: Lucja
authors.initials: L
authors.lastname: Bundy
authors.forename: Adam E
authors.initials: AE
authors.lastname: Locke
authors.forename: Dawn M
authors.initials: DM
authors.lastname: Hall
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D011939:Mental Recall; D010290:Parents; D015203:Reproducibility of Results; D012650:Self Disclosure; D013473:Sunscreening Agents / Q000008:administration & dosage* / Q000032:analysis*; D055815:Young Adult
chemical_list: D013473:Sunscreening Agents